Validity of DXA body volume equations in a four-compartment model for adults with varying body mass index and waist circumference classifications

PLoS One. 2018 Nov 5;13(11):e0206866. doi: 10.1371/journal.pone.0206866. eCollection 2018.

Abstract

The purpose of this investigation was to determine the validity of 4-compartment (4C) model body fat percent (BF%) estimates when using dual energy x-ray absorptiometry (DXA) derived body volume (BV) equations (4C-DXA1 and 4C-DXA2) in adults with varying body mass index (BMI) and waist circumference (WC) classifications. Each model was compared to a criterion 4C model with air-displacement plethysmography (ADP) generated BV (4C-ADP). Participants were categorized as normal weight (n = 40; NW = BMI<25.0kg/m2); overweight (n = 40; OWBMI = BMI≥25.0 kg/m2); and overweight with at-risk WC (n = 35; OWBMI+WC = BMI≥25.0 kg/m2 and WC≥88.0cm for women and 102.0cm for men). 4C-DXA1 produced lower BF% than that derived using the 4C-ADP in NW (CE = -3.0%; p<0.001) while 4C-DXA2 was significantly higher (CE = 4.8%; p<0.001). The SEE and 95% limits of agreement (LOA) were lower for 4C-DXA2 (1.24% and ±2.5%, respectively) than 4C-DXA1 (2.59% and ±5.0%, respectively) and proportional bias was present for both (p<0.05). 4C-DXA1 BF% was not significant in OWBMI (CE = -0.5%; p = 0.112) whereas 4C-DXA2 was higher (CE = 4.5%; p<0.001). The SEE and 95% LOA were lower for 4C-DXA2 (1.20% and ±2.9%, respectively) than 4C-DXA1 (1.92% and ±3.9%, respectively) in OWBMI. Proportional bias was present for 4C-DXA1 (p = 0.007), but not 4C-DXA2 (p = 0.832). 4C-DXA1 and 4C-DXA2 produced significantly higher BF% in OWBMI+WC (CE = 2.2 and 2.3%, respectively; both p<0.001). The SEE and 95% LOA remained lower for 4C-DXA2 (1.15% and ±2.5%, respectively) than 4C-DXA1 (1.84% and ±3.8%, respectively). There was proportional bias for 4C-DXA2 (p = 0.020), but not 4C-DXA1 (p = 0.183) in OWBMI+WC. Only one prediction model (i.e., 4C-DXA1 in OWBMI+WC) revealed valid estimates of BF%. Practitioners are encouraged to use criteria for both BMI and WC when utilizing DXA-derived BV in 4C-models for normal and overweight populations.

MeSH terms

  • Absorptiometry, Photon
  • Adipose Tissue / physiology
  • Adult
  • Body Composition / physiology*
  • Body Mass Index*
  • Female
  • Humans
  • Male
  • Obesity / epidemiology
  • Obesity / physiopathology*
  • Overweight / epidemiology
  • Overweight / physiopathology
  • Plethysmography
  • Waist Circumference*

Associated data

  • figshare/10.6084/m9.figshare.7243070

Grants and funding

The author(s) received no specific funding for this work.